Hendrickson, Dennis & Jean 88705C

❑CAMA ❑ DREDGE & FILL
N4 88705 A B�D
GENERAL PERMIT
prepermit
+
Dateepprrevious permit issued
qNew ❑ Modification ❑ Complete Reissue
❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ti
I SA NCAC I � ❑Rules attached.
®General Permit Rules available at the following link: www.deo.nc ¢ov/CAMArules
``'' �7
Applicant Name Ii% (;%Ni S l l Y AN F 1 � /Jai F-1". a �' U�
Authorized Agent
Address -ii l /1y/{1 r, � �i- L/- t /
Project Location (County):
City _'.. 1417 ( h{I I / State IVI ZIP 2 SIT
Street Address/State Road/Lot#(s)
Phone # ) 259 i ti 4I I
Email i..
�..
Subdivision "
city ZIP
Affected ❑CW EW V]PFA �Es ❑PTS
Adj. Wtr. Body uNP Nth AA L) ;WILL 0Vlt (nat/f�aft/unk)
vv
AEC(s): ❑ OEA ❑ IRA ❑ UW ❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body ��'�i% CIO �ZJ%
ORW: yes/no PNA: yes/©o
Type of Project/ Activity IV PI GE / N AIVUL" �IXA-Tl 67 'I I TTW-M
(Scale:(
Shoreline Length
Access Length '4- ,,,; \✓
�. �' a .:.
Pier (dock) length
u" v tl
Fixed Platform(s)
Floating Platform(s)
j
Finger
Total Platform area
Groin length/p
Bulkhead// iprap length T
Avg distance offshore
Breakwater/Sill
Max distance/ length /+..:`, `
Basin, channel / Cubic yards f
Boat ramp .i
Boathouse/ Boatlift
Beach Bulldozing
Other��il��'�?
SAV observed: yes nog
Moratorium: n/a yes
Site Photos: yes �p
Riparian Waiver Attached: yes o
A building permit/zoning permit may be required by: _
Permit Conditions
i
1
l
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROF
Agent or Applicant PRINTED Name
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please
Permit Othcer's PRINTED Name
Signature "Please read compliance statement on back of permit-*
Application Feels) Check A/Money Order
Signature
2 0
Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
1-1 Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
http:Hportal.ncdenr.org/web/cm/dcm-home
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender Counties)
Revised 6/01/2021

❑CAMA ❑ DREDGE & FILL NO 88705 A B C D
ao Previous permit
3 : GENERAL PERMIT Date previous permit issued
❑ New [_]Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: wwwdecI.nc.gov/CAMArules
Applicant I
Address
City
Phone #
Email
State ZIP
Authorized Agent
Project Location (County):
Street AddreWState Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/maNunk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:
Shoreline Length
Access Length ' -- -� L s
L
Pier (dock) length V
Fixed Platform(s) } i-.."�-. _.. •.J .� -.._ . �` 1k-.-
+_
Floating Platform(s)
Finger piers)
Total Platform area
Groin length/#
Bulkhead/ RipraP length I
-- i i - .... ..y __ .T _........_ �.. _.._._. _..
Avg distance offshore --ra .i!
Breakwater/Sill -
Mazdistance/ length
Basin, channel
Cubic yards
Boat ramp !
Boathouse/ Boatlift
Beach Bulldozing
Other V - '_.. _. .17-711
{ it ti
SAV observed: yes no
Moratorium: n/a - - r
yes no
Site Photos: yes no .. .
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions ❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature --Please read compliance statement on back of permit*- Signature
Application Feels) Check #/Money Order Issuing Date
Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
http:Hportal.ncdenr.org/web/cm/dcm-home
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover and Pender Counties)
Revised 6/01/2021

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ^ ^ jSr� 77 A) -N©2 (G"--O! �_
Mailing Address: sj7n�,ai Yi{t21L rliKE -
Lr
Phone Number: r
Email Address: enc-rLtc(csonl I kkLo _ n e�'
I certify that I have authorized Stephen Perry / Dynamic East Construction
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: n 6W hoas Ot OC4
at my property located at 5 l &(Vst�0NQ DK
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Inform4ion:
,I
IIglIhature
�T-e4+d A he r Oktal- Sa / )
'' II Print or Type Name
�m� (Ii�►Akk
True
�$ I o.1 /C-oaa-
Date
This certification is valid through

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of -Property Ovvner. `-efltJ 4-1-t/I/115 r%tiar/f ICl-Scily
Yddress of Property:
511(a• Bo(7ve SriN�J iPgvv ,
(Lot or Street #, Street or Road, City &County)
Agents Name#:_!Sj�,Vrienl Pe22,1 ` MallinaAddrese l2Zo lVC-ZLl NP.v�Oa(, ��$76
Agents phone #: Sa- �73-��- �/ to
,. I hereby certify that 1 own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing with dimensions must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
Hyouhaveobjectionstowhatisbeingproposed you mustnotifyfheDivision OfCoastaiMmagement
(DCMJ in writing wdbin 10 days of receipt of this notice. Contact information for DCM offices is
available athtfp //www nccoasta/managementnet/web/cm/sWff listing orby piling 1.1t8& dRCOAST.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimurif distance of 19 from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
1 do wish to waive the 15 setback requirement
i do not wish to waive the 15 setback requirement.
(Prope Owner Information)
4Signatu
'J�Ani 1i1c�0(Ltcl=Soft
Print or Type Name
(/a L- O1qR 1L 9a-CL
Mailing Address
�,7 hgpie,�, A)c,
CitylWate2p {yf,CncKSafr�Q(xj .Atf
NOZ5q-lyZ�
elephone Number/Email Address
(Riparian Prope Owner Information)
Stgnatui y,&,
Print or Type Name
O. tewmrd Johnson
Assodde Read of School for Buslnew and FUenea
Mailing A s fSalla of Neuse Rd. Refelgh, No 27stra
Ytf!• ?-WW•IJdMonumvenscroflolp
CityWate/Zip
Telephone Number/ Email Address
Dom.
tRavicaif Amin 9nim

./
In!` '
Here ori:;
?ne of - {
these__ _1
lines -
Initial,LL
Here on-"'
one of
these- I
lines, u
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to T- e/I DK (ol�.sati) 's
�IA, &6,, � SI.>` AJD T(NWe, of Property Owner)
property located a: �'-f�.
(Address, Lot, Block, Road,
on 015�e �oltJD , in glnelu&b
(Waterbody) (City/Tov
N.C.
The applicant has described to me, as shown below, the development proposed at the above
Ih
I I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndnridaal pn posing,devefopmentmust fi%Lin description below or attach a site drawing)
WAIVER SECTION.
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 16from my area of riparian access unless waived by
me. (If you wish to waive the setback, you musi inifial the appropriate blank below.)
I do wish to waive the 16 setback requirement.
I do not wish to waive the 15' setback requirement.
Information)
Print or Type Name
M "n Address Nc a-7 51 -7
�t�tr<tPe L �lr rim/
City tate0p
(ebells��,,neq%
9-zs9-iyz�
Telephone Number/email address
(Adjacent Property Owner information)
AM
Signs pre *
,(bpu.ce- Me�rar
Print or Type Name
MallingAddress ,�. Zyj 4Y
S.,�rs.id Si'�i
..fZZ: 51 Lt-
-I-Z2-
(Revised Aug. 2014/
MroTW Mr nnn ralamiar unar a8nr cinnah,ro-

NEW HOG SLAT UQCKAND WALKWAY
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t Reply v gj Delete (D Report � •••
Re: Dynamic East Riparian Form
You replied on Wed 9/21/2022 11:19 AM
BA Bright, Amy <a bright@ ravenscroft.org >
To: You
Ravenscroft School approves the new drawing.
Please let me know if you need anything else.
Amy T. Bright
Director of Finance
Ravenscroft School
[phone] X 2231
<--� 4-1 r) ...
Wed 9/21/2022 10:54 AM
On Wed, Sep 21, 2022 at 10:48 AM Stephen Perry <stephenperryCd)live.com> wrote:
See attached per our conversation.
Stephen Perry
Dynamic East Construction
Cell: 252-883-9685
Office:252-773-4116
This email and any attachments are confidential and intended solely for use by the individual or entity to whom they are addressed and should not
be disseminated without permission. Any mistransmission waives no confidentiality or privilege. If you have received this email in error, please delete
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if you are not the intended recipient. Any views or opinions expressed are solely those of the author and do not necessarily represent those of
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Ravenscroft reserves the right to monitor all email communications through its networks.
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